As a general rule the opening of the trachea is accompanied by so much disturbance that there often ensues a scene which the elder dramatists would have described as one of "wild excursions and alarums." It is thus depicted by Clinton Wagner:1
The introduction of the knife, together with the flow of blood, produces violent reflex action. The larynx rises and falls spasmodically and very rapidly, and the use of a knife or scissors is fraught with danger. The operator at this moment has need of all his coolness and presence of mind. Blood will find its way into the trachea and lungs, and death on the table from asphyxia may suddenly take place.
Apart from the risk of such a catastrophe, I remember the days when, before opening the trachea, one had to advise the audience to "take cover" behind the head of the operating table, as the